Depression is a serious public health problem facing our society. Although there is a variety of generally effective treatments non-response, partial response, and relapse continue to be problems and there is a need for improved treatments. There are reasons to believe that couple therapy might be a beneficial treatment of depression for some people. The purpose of this K23 Award application is to prepare the candidate to become an independent investigator in psychiatric clinical trials and to conduct a research study on the combination of pharmacotherapy and couple psychotherapy. On-site mentorship at the Wake Forest University School of Medicine will be provided by Dr. David Goldston (Sponsor), Dr. Curt Furberg (Mentor), Dr. Vaughn McCall (Consultant), Dr. Beverly Melton (Biostatistician) and through coursework that is part of an NIH K30 Clinical Research Curriculum Award. Off-site mentorship will be provided by Drs. Donald Baucom and Robert Golden (both at the nearby University of North Carolina at Chapel Hill). Additional guidance will be provided by Dr. Susan Johnson, Dr. Steven Beach, and Dr. David Miklowitz (External Consultants). Short term goals will include: 1) development of a treatment manual for a couple therapy of depression based on emotion focused therapy for couples (EFT), 2) development of a therapist adherence and competence rating for the new intervention, and 3) collection of pilot feasibility data on the new intervention through a small clinical trial of sertraline plus couple therapy to sertraline plus an attention control. The primary hypotheses of this clinical trial will be that depressed individuals treated with the combination of sertraine and couples therapy will have 1) more improvement in levels of depression (and better maintenance of gains) and 2) more improvement in relationship adjustment scores (and better maintenance of gains) than individuals treated with sertraline and an attention control condition. Long term goals include: 1) becoming an independent investigator in psychiatric clinical trials, with skills in couple therapy, pharmacotherapy, and comparative trials, 2) successfully preparing a funded R01 grant application by the conclusion of this award that will consist of a larger clinical trial using pilot feasibility data and other materials developed from the present research, 3) developing a program of research on the role of couples interventions in the treatment of depression to eventually include effectiveness studies.